Mad River Community Hospital Pain Clinic The Mad River Hospital Pain Clinic Nature of Spinal Pain The majority of the patients we see have chronic spinal pain. The spine is a complicated structure. Its components are the bones, joints between the bones, discs, and nerves. In addition to these primary components there are a variety of structures that support the spine, including the muscles. Injury or irritation of any of the primary components of the spine has the potential to cause chronic spinal pain. Once a painful condition occurs the muscles go into spasm to defend the spine from further injury. Although this muscle spasm is also painful, in most patients with chronic pain the muscles are not the primary cause of pain. In some patients the situation is complicated by stress and depression, which frequently accompanies pain, and can even make pain worse. Chronic spinal pain is not a life-threatening condition. However, it can disable patients from work and other activities as well as prevent people from fully enjoying their lives. Diagnosis of Spinal Pain The key tools that doctors use to diagnose the cause of spinal pain are patient history, physical examination, and x-ray studies, including MRI scans. Often the source of pain can be diagnosed using these tools, particularly in patients who have primarily nerve root pain (pain or weakness along the course of a nerve). However, in many patients, particularly those with primarily back or neck pain, it is difficult to localize the exact source of pain. MRI scans are frequently not helpful in these patients. They may show only the normal age-related changes that occur in most people, whether they have pain or not. The nerve supply to the spine is diffuse and overlapping, so a particular pain could have one of several possible causes. Diagnosing the exact source of pain may be difficult, but if your doctor knows the source of your pain, he/she may be able to treat you more effectively. This is particularly true if surgery is being considered. Treatment of Spinal Pain In general, there are four treatment options for patients with chronic spinal pain. Physical therapy can be effective for many people, particularly physical therapy that emphasizes strengthening activity and return to function. For patients who have pain in spite of physical therapy, surgery can sometimes be effective. The success of surgery is highly dependent on an accurate diagnosis as to the source of pain. Another option for patients is to simply live with their pain as best as they can, sometimes with the assistance of a pain medications or other methods. The procedures at the Mad River Pain Clinic are often (not always) helpful in managing pain. In the long run what a person does for himself (weight loss, strengthening, smoking cessation, gentle aerobics such as swimming and walking) is often more effective than what is done for them by another. Risks and Side Effects When done properly, spinal injection procedures are very safe. All of our procedures are done under x-ray guidance, both for safety reasons and to provide the greatest likelihood of success. However, with any medical procedure or treatment come possible risks. Any time a needle is place into the body; there is a risk of bleeding. Usually, any bleeding that occurs after an injection is very minor. However, in rare circumstances bleeding can lead to serious complications. To minimize this risk, we have instructed you to stop taking Plavix and coumadin for one week, and to notify us if you take blood –thinning medications. Another complication that can occur with needle procedures is infection. The chance of getting a significant infection after any needle procedure is very low. However, with certain procedures involving disc injections, including disco grams, a minor infection could lead to a serious complication. For that reason, if you are having a disc injection, antibiotics will be administered to you both intravenously and directly into the disc at the time of the procedure. Preparing For Your Visit Nursing Advice Line: (707)-822-7220 ext. 2131 If these instructions are not followed, your appointment will be cancelled. We appreciate your compliance. If you are taking Coumadin, Plavix or Heparin, please call us.
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primarily on special injection techniques for the treatment of acute and chronic pain conditions. We see patients by referral from other physicians. We send reports and make suggestions when indicated about further diagnostic or treatment options. Everyday management (prescription writing etc...) will remain with your referring physician. Our medical director, Dr. James Jaworski, is an anesthesiologist with over twenty years of experience in pain management and has been board certified by the American Board of Anesthesiology since they began doing so in 1994. Recently joining the team is Thomas Harmon who has been practicing for 7 years. He is a Certified Registered Nurse Anesthetist.